Efficacy of sinonasal simulator in teaching endoscopic nasal skills.

Objectives/hypothesis: To develop a nasal model (NM) which accurately simulates human texture and anatomy and to study the effect of training with NM on performance of video rigid nasal endoscopy and video flexible laryngoscopy. At the conclusion of this presentation, the participants should be able to demonstrate that training with nasal endoscopic simulation enhances efficiency and may improve comfort to the patient.

Study Design: A randomized blinded control trial.

Methods: Twenty medical students without prior endoscopic experience, stratified by prior video game experience, were randomized to training or no training on NM. All participants viewed a 15-minute video instruction on endoscopy. Students randomized to training then practiced on the NM for 15 minutes. All students were tested within 90 minutes of the initial instruction with a timed identification of structures on NM followed by a timed flexible laryngoscopy on a human volunteer who ranked comfort/discomfort on a visual analogue scale.

Results: The students in the training group had a significantly shorter procedure time on NM using rigid nasal endoscopy compared with untrained students (61 seconds vs. 104 seconds, P = .025). The trained students showed a trend, which did not reach statistical significance, toward faster flexible laryngoscopy on the model (23 seconds vs. 32 seconds, P = .085). The trained students had average lower discomfort scores (0.89 vs. 1.33) compared with untrained students, but this did not reach statistical significance.

Conclusions: Our NM accurately simulates human texture and anatomy and provides an opportunity for endoscopic training without concern of bloodborne pathogens and expense of cadavers. Further development of the NM is warranted to expand the training utility.